How many shoppable procedure prices are published for Cincinnati Children's Hospital Medical Center?

Cincinnati Children's Hospital Medical Center in Cincinnati, OH currently has 115 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Cincinnati Children's Hospital Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Cincinnati Children's Hospital Medical Center's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Private 717 Beds · urban Updated: 4/1/2026

Cincinnati Children's Hospital Medical Center

3333 Burnet Avenue, Cincinnati, OH 45229 · 115 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.01×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.01×) after accounting for local nurse/doctor wages and patient complexity.

78/100 · Corroborated

78/100Self-Pay Cash Beats Insurance 72% of the Time

File Completeness85

Price Logic60

Peer Alignment60

Clean Billing91

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Cincinnati Children's Hospital Medical Center prices routine shoppable procedures near 0.8× Medicare (p50 0.65×) while skewing captive emergency, lab, and upper-quartile codes to 1.2× Medicare (p75 1.31×, +102% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#56 of 137 in OH · 40th State Percentile#1,348 of 3,385 in U.S. · 39th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.31× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 72% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (33.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.2× markup over Medicare rates
Captive ER (0.6×) & laboratory (0.8×) services average 1.50× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.31×) jump +102% above the median procedure ratio (Q50 0.65×)
Unnegotiated chargemaster list prices average 7.2× Medicare (18¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.50× Divergence

1.2× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+102% Upper Tail

Q25 0.31× · Q50 0.65× · Q75 1.31×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.2× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.6× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.8× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

72% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Cincinnati Children's Hospital Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 115 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$33,193	$12,716	$19,087	0.7×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$37,714	$8,848	$19,432	0.5×
Total hip replacement CPT Code: `27130`	$5,215	$5,215	$13,413	0.4×
Total knee replacement CPT Code: `27447`	$5,207	$5,207	$13,523	0.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$17,887	$5,103	$8,223	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$2,208	$2,208	$6,109	0.4×
Inguinal hernia repair CPT Code: `49505`	$1,952	$1,952	$3,629	0.5×
Bunion correction surgery CPT Code: `28296`	$1,883	$1,883	$3,446	0.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,836	$1,836	$583	3.1×
Breast lump removal CPT Code: `19120`	$1,176	$1,176	$3,875	0.3×
Rabies immune globulin HCPCS Code: `90375`	$1,020	$1,020	$322	3.2×
Cataract surgery with lens implant CPT Code: `66984`	$3,171	$524	$2,540	0.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,004	$497	$3,372	0.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$255	$429	$181	unverified
Neurobehavioral status check CPT Code: `96116`	$198	$368	$231	1.6×
Family therapy session CPT Code: `90847`	$212	$356	$173	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$324	$324	$185	unverified
Blood transfusion CPT Code: `36430`	$289	$289	$498	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$189	$304	$166	unverified
Care planning with family CPT Code: `90887`	$158	$301	$107	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$200	$292	$110	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$179	$244	$151	1.6×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,860	$193	$1,021	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$760	$213	$1,256	0.2×
Review of medical records for care CPT Code: `90889`	$240	$218	$114	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$482	$182	$86	2.1×
Psychological testing evaluation CPT Code: `96136`	$130	$156	$128	1.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,553	$171	$511	0.3×
Upper endoscopy with biopsy CPT Code: `43239`	$554	$175	$987	0.2×
X-ray, lower back CPT Code: `72110`	$134	$134	$112	1.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$541	$139	$981	0.1×
Prosthetic fitting and training CPT Code: `97761`	$50	$99	$45	2.2×
Group therapy session CPT Code: `90853`	$51	$100	$100	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$91	$91	$93	1.0×
X-ray, shoulder CPT Code: `73030`	$89	$89	$92	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$233	$82	$86	1.0×
X-ray, chest (two views) CPT Code: `71046`	$87	$87	$93	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$873	$87	$258	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$1,169	$107	$343	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$1,166	$101	$338	0.3×
MRI, knee or other leg joint CPT Code: `73721`	$1,136	$107	$369	0.3×
Psychological testing by technician CPT Code: `96138`	$135	$106	$395	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$384	$80	$272	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,141	$99	$448	0.2×
Speech therapy (group session) CPT Code: `92508`	$147	$87	$27	unverified
Typhoid vaccine HCPCS Code: `90675`	$319	$319	$347	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$260	$260	$203	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	$159	$159	$140	1.1×
Culture, blood CPT Code: `87040`	$142	$142	$11	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$50	$51	$38	1.3×
X-ray, hand CPT Code: `73130`	$76	$76	$93	0.8×
X-ray, ankle CPT Code: `73610`	$76	$76	$93	0.8×
X-ray, hip CPT Code: `73502`	$73	$73	$93	0.8×
X-ray, foot CPT Code: `73630`	$72	$72	$92	0.8×
X-ray, chest (single view) CPT Code: `71045`	$69	$69	$92	0.8×
X-ray, pelvis CPT Code: `72170`	$72	$72	$110	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$76	$76	$201	0.4×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$142	$20	$20	1.0×
Orthotic fitting and training CPT Code: `97760`	$86	$38	$51	0.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$126	$57	$123	0.5×
CT scan, chest (no contrast) CPT Code: `71250`	$588	$70	$167	0.4×
CT scan, pelvis CPT Code: `72192`	$646	$66	$163	0.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$626	$68	$168	0.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$693	$68	$169	0.4×
CT scan, sinuses CPT Code: `70486`	$532	$63	$166	0.4×
CT scan, head (no contrast) CPT Code: `70450`	$584	$54	$160	0.3×
CT scan, head (with contrast) CPT Code: `70460`	$710	$74	$242	0.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,101	$76	$303	0.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$282	$47	$134	0.4×
Blood test, calcium CPT Code: `82310`	$32	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$35	$7	$5	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$87	$19	$14	1.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$81	$13	$10	1.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$68	$18	$14	1.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$71	$14	$11	1.3×
Ultrasound, pelvis CPT Code: `76856`	$247	$38	$130	0.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$35	$11	$8	1.4×
Blood test, amylase CPT Code: `82150`	$31	$9	$7	1.3×
Blood test, lipase CPT Code: `83690`	$71	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	$40	$9	$7	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$125	$20	$16	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$34	$5	$4	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$57	$11	$9	1.2×
Blood test, liver function panel CPT Code: `80076`	$55	$11	$9	1.2×
Blood test, vitamin D CPT Code: `82306`	$211	$33	$31	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$234	$34	$126	0.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$207	$34	$132	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$4	$3	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$98	$8	$6	1.3×
Culture, bacterial CPT Code: `87070`	$98	$12	$9	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$91	$25	$19	1.3×
Hepatitis C antibody test CPT Code: `86803`	$98	$19	$15	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$24	$5	$4	1.3×
Blood test, potassium CPT Code: `84132`	$40	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$35	$6	$5	1.2×
Extended office visit (prolonged) HCPCS Code: `G2212`	$77	$24	$33	0.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$136	$17	$25	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$43	$22	$35	0.6×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$67	$23	$38	0.6×
Physical therapy (functional capacity test) CPT Code: `97750`	$73	$23	$38	0.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$43	$23	$40	0.6×
Physical therapy (manual therapy) CPT Code: `97140`	$58	$19	$34	0.6×
Physical therapy (gait training) CPT Code: `97116`	$72	$18	$33	0.5×
Behavioral health living support HCPCS Code: `H2019`	$16	$17	$34	0.5×
Office visit, established patient (20-29 min) CPT Code: `99213`	$97	$42	$87	0.5×
Hepatitis B vaccine HCPCS Code: `90744`	$41	$16	$37	0.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$43	$16	$39	0.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$70	$16	$56	0.3×
Blood antibody screen CPT Code: `86850`	$42	$13	$46	0.3×
Mental health services (assessment) HCPCS Code: `H0031`	$73	$37	$140	0.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$174	$10	$64	0.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$133	$16	$111	0.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$45	$28	$18	unverified
Blood test, hemoglobin CPT Code: `85018`	$13	$13	$3	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$25	$25	$5	unverified

Showing top 25 high-impact procedures of 115 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 33.4%

Audit a Bill or Quote at Cincinnati Children's Hospital Medical Center (Zero PHI Required)

CMS CCN: 363300

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $33,193

Insurer Median $12,716

1. Amount on Your Bill or Quote ($) Pre-filled with Cincinnati Children's Hospital Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $21,738 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $21,738

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (33.4% of gross = $21,738).

Step 2 · Cash vs. Insurance Arbitrage Save $31,891 Paying Cash

Self-Pay Cash Rate ($33,193) Beats Your Bill

Cincinnati Children's Hospital Medical Center's published 45 CFR § 180 self-pay cash rate is $33,193 (vs. $12,716 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$45,997 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($65,084) is $45,997 above the denoised Fair BaseRate ($19,087) and 4.6× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 310833936

Filing Period: 197311

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (33.4% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Cincinnati Children's Hospital Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-23·administrative_or_closure
Closure Notice
Recorded
2025-03-20·warning_notice
Warning Notice
Recorded
2022-05-25·administrative_or_closure
Closure Notice
Recorded
2022-03-09·cap_corrective_action
CAP Request
Recorded
2021-08-25·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Cincinnati Children's Hospital Medical Center.

Price Index: 1.60× regional baseline

Quality: 54/100 CMS composite

Median Household Income$70,816U.S. Census ACS

Local Uninsured Share5.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 78/100 · Corroborated CMS CCN 363300 EIN 310833936

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 363300) ↗ Verify IRS Form 990 (EIN 310833936) ↗ CMS HCRIS Cost Reports ↗

Published MRF File310833936_childrens-hospital-medical-center_standardcharges.csv

Publication / Vintage4/1/2026 · 103.77 MB

Validated Rate Rows12,607 (CMS v3.0.0)

File Integrity Digest8c7a95ad2e557577c932…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy